| Catholic Charities, Diocese Of Gary Inc | |
|
2642 Eleanor St Portage IN 46368-3634 | |
| (219) 762-1177 | |
| (219) 762-1827 |
| Full Name | Catholic Charities, Diocese Of Gary Inc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2642 Eleanor St, Portage, Indiana |
| Authorized Official Name and Position | Duane D Dedelow (DIOCESAN DIRECTOR) |
| Authorized Official Contact | 2198863549 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Catholic Charities, Diocese Of Gary Inc 940 Broadway Gary IN 46402-2906 Ph: (219) 886-3549 | Catholic Charities, Diocese Of Gary Inc 2642 Eleanor St Portage IN 46368-3634 Ph: (219) 762-1177 |
| NPI Number | 1538298401 |
|---|---|
| Provider Enumeration Date | 03/05/2007 |
| Last Update Date | 10/30/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538298401 | NPI | - | NPPES |
| 200085310 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 5603009850243 (Indiana) | Primary |
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